Repeat offender: incorrect PBS items pop up again on PCEHR

Another case of incorrect PBS data being uploaded to the PCEHR has appeared, this time involving six scripts being assigned to the wrong person over a six-month period.

A spokesperson for the Department of Health said the situation was rare, but this is the fourth confirmed case that Pulse+IT is aware of in which incorrect PBS data has been exposed on a consumer's PCEHR.

Three of those cases are understood to be the result of an error by a pharmacist, in which a prescription is filled but the data assigned to the wrong patient in the dispensing system or other pharmacy database. When the pharmacy sends the data to the PBS for claiming, it then automatically appears in the Pharmaceutical Benefits Report section on the consumer's PCEHR.

In Pulse+IT's own experience in 2013, two scripts were dispensed to a patient at my local pharmacy but were mistakenly assigned to my pharmacy record. The erroneous scripts then appeared in the PBS section of my PCEHR, and before the intervention of the Department of Human Services (DHS), were likely to appear again as two repeat scripts were dispensed at a different pharmacy a month later.

In this new case, however, six PBS items for common medications have appeared in a consumer's record but which the consumer says were not prescribed for her. They include a combination antibiotic, dispensed in February last year; a contraceptive pill, a different antibiotic and an asthma inhaler dispensed in July 2014; and another script for the combination antibiotic along with an oral corticosteroid just five days later.

It is not clear as yet whether the scripts were dispensed from the same pharmacy or even whether it is the consumer's regular pharmacy. It is also not clear who the scripts were written for or by.

The consumer rang the PCEHR helpline on Sunday to report the error but was told by the helpline operator to ring back on Monday between 7am and 10pm as weekend staff were only able to assist with technical problems and had no access to individual PCEHRs.

When she rang on Monday night, however, she was told to ring back during business hours so someone with seniority could assist her. It is understood that the issue will be escalated to a specialist PBS team to investigate, with DHS then working to correct the record with the prescriber or the pharmacist.

The DoH spokesperson said it was “an extremely rare occurrence” for incorrect PBS items to be reported to the PCEHR helpline.

“Nonetheless, this is of concern and all reports are investigated as they are considered clinical incidents and therefore are taken very seriously,” the spokesperson said.

“Our investigations have shown that invariably it is an administrative error at the patient’s medical practice or pharmacy but the occurrence of this is extremely rare.”

While ensuring paper scripts are scanned rather than typed into the pharmacy system should reduce these errors even further, an argument can be made that the use of Individual Healthcare Identifiers (IHIs) be mandatory for all transactions involving medications.

The DoH spokesperson said further work will be done to reinforce IHI matching. "Reinforcing messages are provided to healthcare providers as these incidents are resolved, and messages reinforcing the importance of IHI matching with healthcare providers will be included as part of the coming healthcare provider education and awareness program."

In the meantime, another argument can be made that it is only through the PCEHR that these sorts of errors are exposed.

“This report highlights the benefits of having consumers managing their own health records and how that can assist to improve the quality of health information, through consumers actively engaging with their health information, identifying errors and having these rectified,” the Health spokesperson said.